Improving care for people with osteoarthritis of the hip and 'knee : how has national policy for osteoarthritis been translated into service models in Australia?

There is strong rationale for improving care for people with chronic conditions, including osteoarthritis (OA). Successful implementation of healthcare reform requires new concepts and directions that are strongly supported by policy, new models of care (service redesign) and changes in day-to-day practice (healthcare provider and patient practice). In this paper we discuss the extent to which policy about management of OA of the hip and knee has been translated into new service models in Australia. A structured search of government and other key health websites in Australia was performed to identify policy, funding initiatives and new services models for managing OA of the hip and knee. This search was supported by a literature review. Musculoskeletal conditions were designated a National Health Priority in Australia in 2002. Under the Better Arthritis and Osteoporosis Care initiative, Australia has developed a national policy for OA care and national evidence-based clinical practice guidelines for management of OA of the hip and knee. Only two well described examples of new chronic disease management service models, the Osteoarthritis Clinical Pathway (OACP) model and the Osteoarthritis Hip and Knee Service (OAHKS) were identified. Primarily focused within acute care public hospital settings, these have been shown to be feasible and acceptable but have limited data on clinical impact and cost-effectiveness. While policy is extant, implementation has not been systematic and comprehensive. Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently.

Pedagogical practices with digital technologies : pre-service and practicing teachers

In this paper the pedagogical practices of practising teachers and pre- service teachers when using digital technologies are described and compared. Data were collected by observation of presentations about using digital technology in mathematics by teachers and pre-service teachers and practising teachers were interviewed. Teachers generally used pedagogical approaches involving student-centred activity whereas pre-service teachers were more likely to use technology to teach concepts by demonstration and were not inclined to use the more student- centred approaches, though many used guided tasks. The study enabled some analysis and reflection upon the promoted action in the learning environments of pre-service teachers.

Rural and regional Australian public accounting firm services : service provision, concerns and tensions

Public accounting firms provide a necessary and important service for rural and regional areas. However, the provision of high-quality services is hindered by a number of factors. This paper reports the findings from a large-scale survey of professional accounting firm practitioners located in rural and regional Australia, identifying factors causing concerns and tensions and quantifying their scope and importance. Prominent concerns and tensions identified include adverse effects arising from the employment market, communications technology developments and legislation such as the Corporate Law Economic Reform Program (Audit Reform and Corporate Disclosure) Act 2004 and the Financial Services Reform Act 2001.

Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage

AIMS:
To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region.

METHODS:
A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18-30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA(1c), plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire).

RESULTS:
Eighty-six (24%) responses were received [55 (64%) female; mean ± sd age 24 ± 4 years; diabetes duration 12 ± 7 years; HbA(1c) 68 ± 16 mmol/mol (8.4 ± 1.5%)]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30%), transportation (26%) and cost (21%). However, 'a previous unsatisfactory diabetes health experience' was cited as a barrier by 27%. Enablers were largely matched to overcoming these barriers. Over 90% preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19% reported moderate-to-severe depressive symptoms and 50% reported moderate-to-severe anxiety.

CONCLUSIONS:
Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identifiable logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with flexible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcomes in this vulnerable population.

Teaching and learning in the crucible: Actors with disabilities as experts preparing pre-service teachers to be inclusive educators

Dorothy Heathcote understood teaching and learning to take place in a kind of ‘crucible’ in which participants, who are both teachers and learners, contribute to the mix sometimes resulting in a radical transformation. This paper reports the ways Heathcote’s ideas have influenced both research and practice in the Teaching for Diversity workshop - a drama workshop that brings together pre-service teachers, teacher educators and actors from Fusion Theatre, a community-based theatre company for people with intellectual disabilities.

Service providers' experiences and needs in working with refugees in the Geelong region: a qualitative study

Service providers in Geelong, one of the priority locations for the resettlement of refugees in regional Australia, were interviewed to explore their perceptions of the health and wellbeing needs of refugees, and the capacity of service providers in a regional area to meet these. In all, 22 interviews were conducted with health and human service professionals in a range of organisations offering refugee-specific services, culturally and linguistically diverse (CALD) services in general, and services to the wider community, including refugees. The findings revealed that a more coordinated approach would increase the effectiveness of existing services; however, the various needs of refugees were more than could be met by organisations in the region at current resource levels. More staff and interpreting services were required, as well as professional development for staff who have had limited experience in working with refugees. It should not be assumed that service needs for refugees resettled in regional Australia will be the same as those of refugees resettled in capital cities. Some services provided in Melbourne were not available in Geelong, and there were services not currently provided to refugees that may be critical in facilitating resettlement in regional and rural Australia.

Big data sensing and service: a tutorial

As the advance of the Internet of Things (IoT), more M2M sensors and devices are connected to the Internet. These sensors and devices generate sensor-based big data and bring new business opportunities and demands for creating and developing sensor-oriented big data infrastructures, platforms and analytics service applications. Big data sensing is becoming a new concept and next technology trend based on a connected sensor world because of IoT. It brings a strong impact on many sensor-oriented applications, including smart city, disaster control and monitor, healthcare services, and environment protection and climate change study. This paper is written as a tutorial paper by providing the informative concepts and taxonomy on big data sensing and services. The paper not only discusses the motivation, research scope, and features of big data sensing and services, but also exams the required services in big data sensing based on the state-of-the-art research work. Moreover, the paper discusses big data sensing challenges, issues, and needs.

Health service use and costs for infant behaviour problems and maternal stress

AIM: We aim to describe health service (HS) use in the first 6 months post-partum and to examine the associations between service costs, infant behaviour and maternal depressive symptoms. METHODS: Participants were 781 infants and mothers in Melbourne, Australia. Mothers reported infant feeding, sleeping and crying problems, depressive symptoms and health service use. Costs were valued in 2012 Australian dollars. RESULTS: The most common services used were maternal child health nurses, general practitioners (GP) and allied health. Infant feeding problems were associated with increased costs for services relevant to infant behaviour including maternal child health nurses (P = 0.007), GP (P = 0.008) and paediatricians (P = 0.03). Maternal depressive symptoms were associated with increased costs for services relevant to depressive symptoms including parenting centres (P = 0.04), GP (P = 0.004), psychiatrists (P = 0.02) and psychologists (P = 0.001). Mothers who completed high school had higher service costs for infant problems than those with lower education (P = 0.02). Single mothers had higher costs for services used for their depressive symptoms than partnered mothers (P < 0.001). Mothers with English as a second language had lower service costs for their depressive symptoms (P = 0.02). CONCLUSIONS: Infant feeding problems and maternal depressive symptoms are associated with higher costs for health services relevant to these conditions. Cost-effective strategies to manage these conditions are needed with accessibility being ensured for mothers who are experiencing social adversity.

An energy-aware QoS enhanced method for service computing across clouds and data centers

QoS plays a key role in evaluating a service or a service composition plan across clouds and data centers. Currently, the energy cost of a service's execution is not covered by the QoS framework, and a service's price is often fixed during its execution. However, energy consumption has a great contribution in determining the price of a cloud service. As a result, it is not reasonable if the price of a cloud service is calculated with a fixed energy consumption value, if part of a service's energy consumption could be saved during its execution. Taking advantage of the dynamic energy-Aware optimal technique, a QoS enhanced method for service computing is proposed, in this paper, through virtual machine (VM) scheduling. Technically, two typical QoS metrics, i.e., the price and the execution time are taken into consideration in our method. Moreover, our method consists of two dynamic optimal phases. The first optimal phase aims at dynamically benefiting a user with discount price by transparently migrating his or her task execution from a VM located at a server with high energy consumption to a low one. The second optimal phase aims at shortening task's execution time, through transparently migrating a task execution from a VM to another one located at a server with higher performance. Experimental evaluation upon large scale service computing across clouds demonstrates the validity of our method.

Mathematics teacher education and technology

Various applications of electronic technology have contributed to the field of mathematics teacher education, but the array of tools now' available to teacher educators in developed countries can be somewhat daunting. In this chapter, the authors present an overview of some of these tools and the ways that they are being used. In addition, they address issues surrounding the development and applications of digital technology in teacher education programs in a number of countries. In particular, they present recent applications of videotapes, multimedia resources, internet-based communities, and tutorial conferencing facilities in pre-service and in-service education of mathematics teachers. As professionals who have used technology in teacher education, the authors blend their own insights into this review of technological tools and relevant issues.

Relationship between body mass index and the use of healthcare services in Australia

Objective: To examine the relationship between body mass index (BMI) and the use of medical and preventive health services. Research Methods and Procedures: This study involved secondary analysis of weighted data from the Australian 1995 National Health Survey. The study was a population survey designed to obtain national benchmark information about a range of health-related issues. Data were available from 17,033 men and 17,174 women, 20 years or age. BMI, based on self-reported weight and height, was analyzed in relation to the use of medical services and preventive health services. Results: A positive relationship was found between BMI and medical service use, such as medication use, visits to hospital accident and emergency departments (for women only); doctor visits, visits to a hospital outpatient clinics; and visits to other health professionals (for women only). A negative relationship was found in women between BMI and preventive health services. Underweight women were found to be significantly less likely to have Papanicolaou smear tests, breast examinations, and mammograms. Discussion: This research shows that people who fall outside the healthy weight range are more likely to use a range of medical services. Given that the BMI of industrialized populations appears to be increasing, this has important ramifications for health service planning and reinforces the need for obesity prevention strategies at a population level.

Globalisation and manufacturing strategy in the TCF industry

Purpose – The textiles, clothing, and footwear (TCF) industry has struggled in Australia since the government commenced dismantling tariffs. By sourcing from Asia, middlemen undercut established suppliers, and retail chains set benchmark low prices with their imported “house” labels. The policy-makers predicted that local producers would become more efficient, and export to make up for lost sales, but the media paints a picture of rising imports, retrenchments, and factory closures. The research objective was to discover what strategies the survivors (actually) employ in adapting to the pressures of globalisation.

Design/methodology/approach – More than 30 companies were involved in the study, ranging from small family businesses to subsidiaries of big multinationals. Each case study was based on an interview with a senior executive, normally followed by a plant tour. This methodology suits a fresh topic, as it avoids preconceptions and imposes no bounds.

Findings – Results show that the policy change was based on “pie in the sky” forecasts. Increasingly, TCF production is transferred to cheap offshore locations, generally via subcontracting plus the “badging” of foreign designs. To survive, local factories should focus on quality and customer service, preferably in niche markets (like uniforms), or for specific customer groups, and develop technologically advanced products. A move down the supply chain into retailing can also assist. Large multinational corporations that engage in foreign direct investment dominate the management literature.

Originality/value – This paper presents a different perspective, neglected in international operations management, whereby domestically oriented businesses attempt to defend themselves against the adverse consequences of globalisation.

How acceptable is a referral and telephone-based outcall programme for men diagnosed with cancer? A feasibility study

The objective of this study was to determine the feasibility and acceptability of a referral and outcall programme from a telephone-based information and support service, for men newly diagnosed with colorectal or prostate cancer. A block randomized controlled trial was performed involving 100 newly diagnosed colorectal and prostate cancer patients. Patients were referred to the Cancer Information Support Service (CISS) through clinicians at diagnosis. Clinicians were randomized into one of three conditions. Active referral 1: specialist referral with four CISS outcalls: (1) ≤1 week of diagnosis; (2) at 6 weeks; (3) 3 months; and (4) 6 months post diagnosis. Active referral 2: specialist referral with one CISS outcall ≤1 week of diagnosis. Passive referral: specialist recommended patient contacts CISS, but contact at the patient's initiative. Patients completed research questionnaires at study entry (before CISS contact), then 4 and 7 months post diagnosis. Overall, 96% of participants reported a positive experience with the referral process; 87% reported they were not concerned about receiving the calls; and 84% indicated the timing of the calls was helpful. In conclusion, the referral and outcall programme was achievable and acceptable for men newly diagnosed with colorectal or prostate cancer.

Issues in IT service-oriented requirements engineering

Corporate information technology (IT) management is increasingly service-oriented, offering continuous evaluation and improvement of application, communication, delivery and support services to internal and external customers. Service-oriented requirements engineering (SoRE) plays a significant role in identifying and specifying service requirements, formally defined through service-level agreements (SLAs). However, the new frameworks and approaches emerging to guide these developments have not yet addressed how requirements for such services can be effectively developed, nor identified the diverse issues involved. We report a case study of a web services team development of requirements for an internal Service Desk service. The study revealed five main issues of concern when developing service provider requirements: service roles, responsibilities and accountability; service performance metrics; resolution of conflicting stakeholder service requirements; customer acceptance of service change; and service provider team structure. This study suggests that in the new IT services era, new techniques and approaches are needed for eliciting and determining provider and customer requirements that involve key stakeholder groups equitably and more closely negotiate the sometimes-conflicting provider and customer needs.

Re-envisioning teacher education in the new media age: multiliteracies, multimodality and internet communication technologies

Multiliteracies pedagogy and research (New London Group, 1996) addresses the range of literacies needed by diverse students to effectively negotiate the increasing multimodality of texts, both inside and outside of schools. Yet, few university teachers understand how youth are able to express themselves, their experiences and lives, in new, empowering and perception-shifting ways as designers in the 21st century. Several theorists (Bruce, 2000; Lemke, 1998; Luke, 2000; Bolter, 1998; Glister, 1997) argue literacy education must be reconceptualised to recognize the importance of teaching and supporting multimedia literacy in a world where internet communication technologies (ICTs) incorporate all semiotic resources. Expression through multiple media and more recently hypermedia—is common to youth—but has often been demonized by historically logocentric approaches to teaching and assessment by privileging print, over all other forms of expression (Albright & Walsh, 2003; Lemke, 1998; McCloud, 1993). As digital media becomes more pervasive in a post-typographic world, tertiary education will need to engage with its representational resources for acquiring traditional school literacy and knowledge. This paper reports on initiatives in Multiliteracies instruction for both pre-service and in-service teachers to more adequately attend to the multisemiotic landscapes of students’ changing worlds in New Times (Hall, 1996).